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Modelling NAFLD disease burden in four Asian regions-2019-2030

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Estes C, Chan HLY, Chien RN, Chuang WL, Fung J, Goh GB, Hu TH, Huang JF, Jang BK, Jun DW, Kao JH, Lee JW, Lin HC, Razavi-Shearer K, Seto WK, Wong GL, Wong VW, Razavi H. Modelling NAFLD disease burden in four Asian regions-2019-2030. Aliment Pharmacol Ther. 2020 Apr;51(8):801-811. doi: 10.1111/apt.15673. Epub 2020 Mar 4. PMID: 32133676; PMCID: PMC7154715.



Summary

Background

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) account for an increasing proportion of liver disease in the Asia-Pacific region. Many areas in the region are experiencing epidemics of metabolic syndrome among rapidly ageing populations.

Aims

To estimate using modelling the growth in NAFLD populations, including cases with significant fibrosis that are most likely to experience advanced liver disease and related mortality.

Methods

A disease progression model was used to summarise and project fibrosis progression among the NAFLD populations of Hong Kong, Singapore, South Korea and Taiwan. For each area, changes in the adult prevalence of obesity was used to extrapolate long-term trends in NAFLD incidence.

Results

In the areas studied, prevalent NAFLD cases were projected to increase 6%-20% during 2019-2030, while prevalent NASH cases increase 20%-35%. Incident cases of hepatocellular carcinoma are projected to increase by 65%-85%, while incident decompensated cirrhosis cases increase 65%-100% by 2030. Likewise, NAFLD-related mortality is projected to increase between 65% and 100% from 2019 to 2030. NAFLD disease burden is expected to increase alongside rising trends in metabolic syndrome and obesity among populations in the region. This leads to more cases of advanced liver disease and associated mortality.

Conclusions

Preventing the growth of diabetic and obese populations will be a key factor in reducing ongoing increases in NAFLD-related disease burden in the Asia-Pacific region.

Countries: Hong Kong, Singapore, South Korea, Taiwan

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